Cognitive Impairment is Associated with Mortality in Hemodialysis Patients.
J Alzheimers Dis
; 66(4): 1529-1537, 2018.
Article
em En
| MEDLINE
| ID: mdl-30412499
ABSTRACT
BACKGROUND:
The prevalence of cognitive impairment in hemodialysis patients is notably high. In previous studises performed in the general population, cognitive impairment has been associated with increased mortality.OBJECTIVE:
We evaluated the relationship between global cognitive function tested by a short screening instrument and mortality in hemodialysis patients.METHODS:
Cognitive testing was performed in 242 maintenance hemodialysis patients under standardized conditions at baseline using the Montreal Cognitive Assessment (MoCA).Cognitive impairment was defined as a MoCA test score ≤24 points, as published previously. All-cause mortality was monitored during a median follow-up of 3.54 years. Kaplan-Meier plot and Cox regression model adjusted for known risk factors for mortality in hemodialysis patients were used to examine a possible association between global cognitive function and all-cause mortality.RESULTS:
A MoCA test score ≤24 points resulted in a significant almost 3-fold higher hazard for all-cause mortality (unadjusted hazard ratio [HR] 2.812; 95% confidence interval [95% CI] 1.683-4.698; pâ<â0.001). After adjustment, this association was attenuated but remained significant (adjusted HR 1.749; 95% CI 1.007-3.038; pâ=â0.047).CONCLUSION:
Impairment of global cognitive function measured by a short screening instrument was identified for the first time as an independent predictor of all-cause mortality in hemodialysis patients. Thus, implementing the MoCA test in clinical routine could contribute to a better risk stratification of this patient population.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Diálise Renal
/
Disfunção Cognitiva
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Falência Renal Crônica
Tipo de estudo:
Etiology_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article